anajemen Mutu dalam Hospital Disaster Plan

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Indra Dharmawijaya
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1 anajemen Mutu dalam Hospital Disaster Plan Hanevi Djasri Divisi Manajemen Mutu Pusat Manajemen Pelayanan Kesehatan (PMPK) FK UGM

2 darurat vs mutu

3 Hospital disaster plan

4 Sistem manajemen mutu Simulasi atau bencana sesunguhnya

5 Darurat vs Mutu

6 Latar belakang perlunya manajamen mutu dl dalam HDP 1. Meningkatkan efektifitas 2. Meningkatkan profesionalisme 3. Menunjukkan status kesiap siaga an i kepada institusi terkait 4. Menjadi dasar analisa kemampuan operasional sebelum dan sesuah bencana 5. Menciptakan budaya kesiap siaga an bencana ERI international Inc.: Capabilities Assessment for Readiness,(CAR 2000)

7 Siklus jaminan mutu Implementation Develop standards Quality Action Quality Appraisal Improvement plan Assess compliance rate

8 tidak diukur tidak bisa diperbaiki

9 Apa yang perlu dinilai? 1. Assessment of capabilities: identifying shortcomings and bottlenecks; 2. Assessment of compliance with national doctrines and protocols; 3. Performance assessment: review of functions during drills; 4. Assessment of needs: identifying i organizational needs for improvement in relevant areas of planning, equipment, training, etc.; and 5. Assessment of preparedness strategies: standardization of planning, and inter organizational cooperation. Government Accountability Office: DHS Efforts to Enhance First Responders: All Hazards Capabilities Continue to Evolve, July 2005

10 Komponen penilaian (1) elements of disaster planning; (2) emergency coordination; (3) internal and external communication; (4) training; (5) expansion of the surge capacity of hospitals; (6) staffing and personnel; (7) availability of equipment; (8) stockpiles of pharmaceuticals; (9) expansion of laboratory capacities. Agency for Healthcare Research and Quality. Emergency Planning and Preparedness: (2003) Health Resources and Services Administration: A 2002 National Assessment of State Trauma System Development, Emergency Medical Services Resources, and Disaster Readiness for Mass Casualty Events 2003.

11 Baseline penilaian Diperlukan untuk u Meningkatkan kesiapsiagaan Mengidentifikasi kekuatan dan kelemahan improvement (1) resource management; age e (2) emergency management plans; (3) direction, control, and coordination; (4) operational procedures; (5) communication; (6) logistics; and (7) public information.

12 Parameter yang sedang dikembangkan (1) regional linkages; (7) public health (2) planning and structure surveillance; of response to (8) surge capacity; bioterrorism; (9) lb laboratories; (3) training and exercises; (10)vaccinations and (4) triage, diagnosis, and pharmacies; treatment of casualties; (11)safety and mental (5) decontamination health support; and capabilities; (12)information systems and (6) isolation and control of public relations infectious diseases; Agency for Healthcare Research and Quality. Emergency Planning and Preparedness: (2003)

13 Alat ukur Valid Dapat diukur Dipercaya Membangun kesimpulan tentang efektifitas RS dalam kesiapsiagaan bencana Raisbeck G: How the choice of measures of effectiveness constrains operational analysis.interfaces 1979;9(4):85 93.

14 Alat ukur Jelas Mudah dimengerti Dipercaya Simpel Informatif cost effective and task relevant bahasa yang sama untuk semua institusi yang terlibat dalam mengatasi bencana Burkle FM Jr.: Measures of effectiveness in large scale bioterrorism events. Prehosp Disast Med 2003;18(3):

15 Alat ukur yang telah ada 1. Tools for assessing levels of emergency preparedness (The Joint Commission for the Accreditation of Healthcare Organizations) 2. Parameters and checklists as part of the assessment process (Healthcare Association of Hawaii) 3. Capabilities i Evaluation (The Capabilities i Assessment for Readiness/CAR)

16 1. Tools for assessing levels of emergency preparedness: 1) Keterlibatan pimpinan dalam perencanaan 2) Tingkat pemahaman staf terhadap HDP 3) clinical leadership; 4) Penatalaksanaan lingkungan Kritik: Struktur+Proses vs Kinerja

17 2. Parameters aa eesand Checklists s as Part of the Assessment Process (1) leadership; (2) hazard identification, analysis, and control; (3) planning; (4) direction, control, and coordination; (5) communications; (6) operations and procedures; (7) resources management; (8) logistics and facilities; (9) public information; (10) orientation and training; (11) exercise; (12) performance improvement

18 3. Capabilities Evaluation Berbeda dengan yang lain, fokus kepada (1) identifying the weak links in preparedness; and (2) serving as a basis to perform the actionsrequired to strengthen emergency preparedness. Digunaikan untuk 2 tujuan utama: (1) establishing a database of information for local governments that can be used as part of the needs analysis; and (2) strategic planning and national implementation of readiness for emergencies

19 Penilaian self assessment 3 hal utama yang gperlu dinilai: 1. Preparedness planning harus teritegrasi dengan institusi lain. Menjelaskan peran dari para staf, rencana dan kegiatan mudah dhdiakses (diketahui) i) oleh lh para staf, selalu dilatih dan diupdate 2. Individual worker competency parastaf hasur kompeten, RS perlu melakukan training needs assessment 3. Exercise and simulation HDP telah diuji coba dan para staf telah menunjukkan kompetensinya dengan baik Quarentelli EL: Research Based Criteria for Evaluating Disaster Planning and Managing. International Seminar on Chernobyl and Beyond: Humanitarian Assistance to Victims of Technological Disasters. Moscow, Russia: Department of Humanitarian Affairs of the United Nations, 1997.

20 Contoh hasil pengukuran Rüter A,Nilsson H,Vilkström T:Performance indicators as quality control for testing and evaluating hospitalmanagementgroups: groups: A pilot study. Prehosp Disast Med 2006;21(6):

23 Results: The management group that scored lowest in management skills also scored lowest in staff skills.

24 Keterbatasan Tools yang ada belum komprehensif Perlu dikembangkan tools dengan: 1. Menentukan standar untuk kkinerja 2. Menentukan paramenter untuk kesiap siagaan 3. Mengembangkan alat ukur untuk evaluasi 4. Mengembangkan sistem untuk belajar dari temuan (tindak lanjut)

25 Penutup Perlu adanya kerjasama antar institusi di Indonesia untuk mengembangkan standar, kriteria dan instrumen yang dapat digunakan dalam peningkatan kesiapsiagaan RS menghadapi bencana

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